CPB Corporate Partnership Board Exposure-Adjusted Road Fatality Rates for Cycling and Walking 168 Roundtable Alberto Castro in European Countries University of Zurich Sonja Kahlmeier Discussion Paper University of Zurich Thomas Gotschi University of Zurich CPB Corporate Partnership Board Exposure-Adjusted Road Fatality Rates for Cycling and Walking 168 Roundtable Alberto Castro in European Countries University of Zurich Sonja Kahlmeier Discussion Paper University of Zurich Thomas Gotschi University of Zurich The International Transport Forum The International Transport Forum is an intergovernmental organisation with 59 member countries. It acts as a think tank for transport policy and organises the Annual Summit of transport ministers. ITF is the only global body that covers all transport modes. The ITF is politically autonomous and administratively integrated with the OECD. The ITF works for transport policies that improve peoples’ lives. Our mission is to foster a deeper understanding of the role of transport in economic growth, environmental sustainability and social inclusion and to raise the public profile of transport policy. The ITF organises global dialogue for better transport. We act as a platform for discussion and pre‐ negotiation of policy issues across all transport modes. We analyse trends, share knowledge and promote exchange among transport decision‐makers and civil society. The ITF’s Annual Summit is the world’s largest gathering of transport ministers and the leading global platform for dialogue on transport policy. The Members of the Forum are: Albania, Armenia, Argentina, Australia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Canada, Chile, China (People’s Republic of), Croatia, Czech Republic, Denmark, Estonia, Finland, France, Former Yugoslav Republic of Macedonia, Georgia, Germany, Greece, Hungary, Iceland, India, Ireland, Israel, Italy, Japan, Kazakhstan, Korea, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Mexico, Republic of Moldova, Montenegro, Morocco, the Netherlands, New Zealand, Norway, Poland, Portugal, Romania, Russian Federation, Serbia, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine, the United Arab Emirates, the United Kingdom and the United States. International Transport Forum 2 rue André Pascal F‐75775 Paris Cedex 16 contact@itf‐oecd.org www.itf‐oecd.org ITF Discussion Papers ITF Discussion Papers make economic research, commissioned or carried out in‐house at ITF, available to researchers and practitioners. They describe preliminary results or research in progress by the author(s) and are published to stimulate discussion on a broad range of issues on which the ITF works. Any findings, interpretations and conclusions expressed herein are those of the authors and do not necessarily reflect the views of the International Transport Forum or the OECD. Neither the OECD, ITF nor the authors guarantee the accuracy of any data or other information contained in this publication and accept no responsibility whatsoever for any consequence of their use. This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Comments on Discussion Papers are welcome. Cite this work as: Castro, A., S. Kahlmeier and T. Gotschi (2018), “Exposure‐adjusted Road Fatality Rates for Cycling and Walking in European Countries”, Discussion Paper, International Transport Forum, Paris. Acknowledgements This research was co‐funded by the European project Physical Activity through Sustainable Transportation Approaches (PASTA). PASTA (http://www.pastaproject.eu/) was a 4‐year project (2013 ‐ 2017) with 14 partners co‐funded by the European Union’s Seventh Framework Program under EC‐GA No. 602624‐2 (FP7‐HEALTH‐2013‐INNOVATION‐1). The writing of this article was additionally supported by the International Transport Forum for the ITF Roundtable on Cycling Safety (Paris, 29 and 30 January 2018). The authors present this research on behalf of the Health Economic Assessment Tool (HEAT) core group, which includes the following persons: Harry Rutter (London School of Hygiene and Tropical Medicine, United Kingdom), Francesca Racioppi (WHO Regional Office for Europe), Sonja Kahlmeier, (University of Zurich, Switzerland), Thomas Götschi (University of Zurich, Switzerland), Nick Cavill, (Cavill Associates, United Kingdom), James Woodcock (University of Cambridge, United Kingdom), Paul Kelly (University of Edinburgh, United Kingdom), Christian Brand (University of Oxford, United Kingdom), David Rojas‐Rueda (Barcelona Institute for Global Health, ISGlobal, Spain), Alberto Castro, (University of Zurich, Switzerland), Christoph Lieb (Ecoplan, Switzerland), Heini Sommer, (Ecoplan, Switzerland), Pekka Oja (UKK Institute for Health Promotion Research, Finland), Charlie Foster (University of Bristol, United Kingdom). The HEAT development has been supported by a range of donors and experts, which are fully acknowledged on the HEAT website (http://www.heatwalkingcycling.org/#acknowl). Corrigenda: Figures 1, 2 and 3 have been amended to reflect United Kingdom data (07 June 2021). EXPOSURE‐ADJUSTED ROAD FATALITY RATES FOR CYCLING AND WALKING IN EUROPEAN COUNTRIES | DISCUSSUION PAPER | ITF ROUNDTABLE 168 Table of contents Introduction ........................................................................................................................................... 5 Method .................................................................................................................................................. 7 Fatality data ....................................................................................................................................... 8 Exposure data .................................................................................................................................... 8 Results .................................................................................................................................................. 10 Discussion ............................................................................................................................................. 19 Conclusions .......................................................................................................................................... 24 Notes .................................................................................................................................................... 25 References ........................................................................................................................................... 26 4 © OECD/ITF 2018 EXPOSURE‐ADJUSTED ROAD FATALITY RATES FOR CYCLING AND WALKING IN EUROPEAN COUNTRIES | DISCUSSUION PAPER | ITF ROUNDTABLE 168 Introduction Physical inactivity is a significant public health problem in most regions of the world, which is unlikely to be solved by classical health promotion approaches alone (1). The promotion of active transport (cycling and walking) for everyday physical activity is a win‐win approach; it not only promotes health but also has benefits from an urban and transport planning perspective, as well as positive environmental effects, especially if cycling and walking replace short car trips. Cycling and walking are particularly space‐ and cost‐effective transport options that can also be readily integrated into people’s busy daily schedules as a practical and feasible form of regular physical activity. There is large potential for active travel in urban transport, as many trips are short and would often be amenable to being undertaken on foot or by bicycle (2). This, however, requires effective partnerships between involved sectors, such as health and environment and the transport and urban planning sectors, whose policies are driving forces in providing safe and convenient conditions for active transport to thrive. In particular, concerns about traffic safety have been found to be a major barrier to taking up active transport (3). Since 2002, Member States of the World Health Organisation (WHO) European Region are collaborating under the Transport, Health and Environment Pan‐European Programme (THE PEP) (4). THE PEP is an inter‐sectoral policy platform supported by the WHO and the UNECE, to facilitate dialogue, exchange of experiences and good practices and the establishment of partnerships among representatives of ministries of health, transport and environment, with the ultimate aim of promoting healthy and sustainable transport options. One of the on‐going partnerships under THE PEP is the promotion of active mobility and support to the development of policies in this area. In particular, THE PEP is currently supporting the development of a Pan‐European master plan for cycling promotion, which is expected to be adopted at the 5th High Level Meeting on Transport, Health and Environment, to take place in Vienna, Austria, in 2019 (5). Within this framework, coordinated by the WHO/Europe, steered by a core group of multi‐disciplinary experts and supported by ad‐hoc invited relevant international experts, an open‐ended project was started in 2005 to develop the Health Economic Assessment Tool (HEAT) for Walking and Cycling (www.heatwalkingcycling.org) with the aim to foster the integration of the appreciable health benefits of regular physical activity through walking and cycling into economic appraisals